During certain invasive intravascular procedures such as percutaneous transluminal coronary angioplasty (PTCA), a number of devices are inserted into and removed from the patient's cardiovascular system through an opening, for example, in the femoral artery. In a typical procedure, a guide catheter with a diameter of approximately 8 French will be advanced distally within the patient's arterial system and then a guidewire will be advanced within the guide catheter, to the point that the distal portion of the guidewire will be maneuvered to a point distal to the distal end of the guide catheter. Then, dependent upon the particular procedure being performed, one or more different catheters will be advanced over the guidewire, including situations where one catheter may be "exchanged" for another over the guidewire.
Typically at the proximal end of the guide catheter there will be a "Y" adaptor having two or more manifolds or ports for the introduction of and removal of guidewires, catheters, and the like. In some instances an additional Y-adaptor may be linked to another Y-adaptor.
One characteristic of the Y-adaptors is that they are preferably able to tighten, that is, "clamp down", onto a device such as a catheter to be inserted, to hold the catheter in position as well as to minimize blood leakage and to allow simultaneous monitoring of blood pressure. Existant Y-adaptors have the drawback that they sometimes will damage expensive, mechanically fragile catheters when the clamp is tightened or inhibit intracatheter movement. In addition, there may be a significant blood loss, particularly during certain catheter exchanges.
In recognition of the aforementioned problems at least one company has developed a modified Y-adaptor that has an O-ring arrangement. However, that arrangement is specific to that one particular company's Y-adaptor. Also, some cardiologists have adopted commercially available Y-adaptors by adding additional O-rings to minimize bleed-back during catheter exchanges. However, this is a cumbersome and unacceptable procedure.